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Article

The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever

by
Marcello Covino
1,2,*,
Antonella Gallo
3,
Massimo Montalto
2,3,
Giuseppe De Matteis
3,
Maria Livia Burzo
4,
Benedetta Simeoni
1,
Rita Murri
2,5,
Marcello Candelli
1,
Veronica Ojetti
1,2 and
Francesco Franceschi
1,2
1
Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCSS, 00168 Rome, Italy
2
Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
3
Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCSS, 00168 Rome, Italy
4
Emergency Department, Ospedale Generale M.G. Vannini, Istituto Figlie di San Camillo, 00177 Rome, Italy
5
Department of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
Medicina 2021, 57(2), 179; https://doi.org/10.3390/medicina57020179
Submission received: 5 January 2021 / Revised: 13 February 2021 / Accepted: 16 February 2021 / Published: 19 February 2021
(This article belongs to the Special Issue New Strategies for Treatment of Sepsis)
Review Reports Versions Notes

Abstract

Background and Objectives: Fever is one of the most common presenting complaints in the Emergency Department (ED). The role of serum procalcitonin (PCT) determination in the ED evaluation of adults presenting with fever is still debated. The aim of this study was to evaluate if, in adults presenting to the ED with fever and then hospitalized, the early PCT determination could improve prognosis. Materials and Methods. This is a retrospective, mono-centric study, conducted over a 10-year period (2009–2018). We analyzed consecutive patients ≥18 years admitted to ED with fever and then hospitalized. According to quick sequential organ failure assessment (qSOFA) at admission, we compared patients that had a PCT determination vs. controls. Primary endpoint was overall in-hospital mortality; secondary endpoints were in-hospital length of stay, and mortality in patients with bloodstream infection and acute respiratory infections. Results. The sample included 12,062 patients, median age was 71 years and 55.1% were men. In patients with qSOFA ≥ 2 overall mortality was significantly lower if they had a PCT-guided management in ED, (20.5% vs. 26.5%; p = 0.046). In the qSOFA < 2 group the mortality was not significantly different in PCT patients, except for those with a final diagnosis of bloodstream infection. Conclusions. Among adults hospitalized with fever, the PCT evaluation at ED admission was not associated with better outcomes, with the possible exception of patients affected by bloodstream infections. However, in febrile patients presenting to the ED with qSOFA ≥ 2, the early PCT evaluation could improve the overall in-hospital survival.
Keywords: procalcitonin; emergency department; qSOFA; sepsis; fever procalcitonin; emergency department; qSOFA; sepsis; fever

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MDPI and ACS Style

Covino, M.; Gallo, A.; Montalto, M.; De Matteis, G.; Burzo, M.L.; Simeoni, B.; Murri, R.; Candelli, M.; Ojetti, V.; Franceschi, F. The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever. Medicina 2021, 57, 179. https://doi.org/10.3390/medicina57020179

AMA Style

Covino M, Gallo A, Montalto M, De Matteis G, Burzo ML, Simeoni B, Murri R, Candelli M, Ojetti V, Franceschi F. The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever. Medicina. 2021; 57(2):179. https://doi.org/10.3390/medicina57020179

Chicago/Turabian Style

Covino, Marcello, Antonella Gallo, Massimo Montalto, Giuseppe De Matteis, Maria Livia Burzo, Benedetta Simeoni, Rita Murri, Marcello Candelli, Veronica Ojetti, and Francesco Franceschi. 2021. "The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever" Medicina 57, no. 2: 179. https://doi.org/10.3390/medicina57020179

APA Style

Covino, M., Gallo, A., Montalto, M., De Matteis, G., Burzo, M. L., Simeoni, B., Murri, R., Candelli, M., Ojetti, V., & Franceschi, F. (2021). The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever. Medicina, 57(2), 179. https://doi.org/10.3390/medicina57020179

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